As a newly minted U.S. citizen, Ramona Matos, as soon as a health care provider in Cuba, didn’t hesitate when deciding whom to vote for final 12 months.
She selected Donald J. Trump, the candidate who promised to be powerful on Cuba’s communist authorities.
She hoped he would assist free the Cuban individuals and, particularly, put an finish to a device the federal government in Havana has used to melt its picture around the globe — one which Ms. Matos discovered notably repugnant for private causes.
For many years, the Cuban authorities has despatched 1000’s of well being professionals to work in distant villages and cities in dozens of nations, the place they get only a fraction of what the international locations pay Cuba for his or her providers.
“These medical doctors are slaves to the Cuban dictatorship,” stated Ms. Matos, 63, who, after posts at Cuban medical missions in Bolivia and Brazil, is a manufacturing unit employee in South Florida.
Starting on his first day in workplace, Mr. Trump has began tightening the screws on Cuba, together with on its international medical program.
With a Cuban American secretary of state and an envoy to Latin America referred to as a longtime hawk on Cuba coverage, the Trump administration shortly imposed harder measures. It was the most recent twist within the back-and-forth method towards Cuba, which shifts from aggression to softening, relying on who occupies the White Home.
The Trump administration reversed strikes made by the Biden administration, returning Cuba to the record of state sponsors of terrorism, which limits its means to do enterprise around the globe, and restoring the best of Individuals to sue over property confiscated on the island a long time in the past.
Cuban officers have had their visas yanked and the administration has prohibited enterprise transactions with firms controlled by Cuba’s military, intelligence and security services, which handle very important pursuits equivalent to tourism and imports.
Republican administrations have tried to focus on Cuba’s medical missions earlier than, however Mr. Trump is taking a more durable line: In February, for the primary time, the U.S. authorities stated it might withdraw the journey visas of officers in international locations that host the medical brigades.
The measure threatens certainly one of Cuba’s primary sources of foreign money, simply because the nation grapples with an enormous wave of migration, widespread energy outages and meals shortages.
It’s troublesome to determine precisely how a lot the medical program generates for Cuba — consultants observe that the federal government’s figures are sometimes unclear, as a result of it regularly adjustments the descriptions of the funds and lumps collectively completely different sorts of providers.
General, Cuba earns greater than $4 billion a 12 months by exporting well being care workers, development staff, educators and different sorts of expert staff, based on a study by Cuba Archive, a Miami-based human rights group, which produced the findings for the State Division’s annual Trafficking in Persons report.
4 authorities officers, two from Venezuela and two from Cuba, have misplaced their journey visas to the US over the brand new medical brigade coverage, the U.S. State Division stated.
“I don’t agree with every thing Trump does, however as regards to Cuba, I discover it great,” Ms. Matos stated.
Cuba’s medical brigades work in dozens of nations from Africa to South America and the Caribbean.
Although they’re usually depicted as humanitarian missions for nations in want of well being care, the international locations pay Cuba for medical doctors, nurses, technicians and different service suppliers, serving to the Cuban authorities fund its personal well being care system.
Cuban officers say the nation at the moment has 24,000 individuals posted in 56 international locations. This system peaked in 2014 however has declined over the previous decade due to disputes with Brazil and cutbacks in Venezuela.
The well being staff, who examine medication totally free in Cuba, usually take part in this system willingly as a result of they earn excess of they might at house.
However they solely obtain a portion — human rights activists say 2 to fifteen % — of what governments pay Cuba for his or her providers. Half of the employees’ pay is held in a devalued native foreign money account in Cuba, from which they will withdraw solely after returning house from their assignments.
Docs who served abroad say their passports have been taken from them, they weren’t allowed to socialize with locals and, in some communities, needed to preserve a 6 p.m. curfew. Additionally they couldn’t convey their households. Below the administration of President George W. Bush, medical doctors who fled this system have been provided fast-track entry into the US, and lots of abandoned.
One physician who fled in 2019 stated the month-to-month wage she acquired in Venezuela’s native foreign money throughout a interval of hyperinflation was sufficient to purchase only a loaf of bread and a can of soda. She labored 48-hour shifts, usually with out electrical energy, and bunked with three different Cuban medical doctors.
“It’s a Cuban authorities enterprise, actually,” stated the physician, who requested that she solely be recognized by her first title, Leydy, as a result of the federal government generally harasses her household at house. “The reality is, it’s exploitation.”
Leydy is now learning to be a nurse practitioner in Florida. As a result of she by no means returned to Havana, the Cuban authorities saved the $10,000 she earned in Venezuela over 15 months, she stated.
Maria Werlau, the manager director of Cuba Archive, the Miami-based human rights group, described this system as “a scheme for compelled labor.”
The quantity governments have paid Cuba per physician varies, starting from $900 in Guatemala to $5,000 in Kenya. In Equatorial Guinea, medical doctors acquired $1,000 of the $10,000 the federal government paid for them, Cuba Archive’s report stated.
Ms. Werlau famous that U.S. federal legislation requires sanctions towards international locations that take part in trafficking. Whereas the State Division has accused Cuba of labor trafficking for years, Ms. Werlau believes the US also needs to penalize governments that take part in this system.
The Cuban authorities insists that the medical program doesn’t meet the worldwide authorized definition of labor trafficking as a result of workers usually are not tricked and know the place they’re going.
The workers obtain a wage, pension and a “first rate” stipend within the vacation spot nation, the place their lodging, transportation and sometimes meals bills are coated, Cuba’s deputy international minister, Carlos F. de Cossío, stated in an emailed response to questions.
“The Cuban professionals who take part achieve this voluntarily,” he stated.
Mr. de Cossío stated they’ve “full freedom of motion,” an assertion human rights activists say tons of of medical doctors who’ve left this system have disputed.
No international locations have withdrawn from this system due to the brand new coverage, Mr. de Cossío stated.
Mr. Trump’s coverage to cancel visas from officers of nations that take part in this system “is aimed toward strangling the Cuban financial system via threats and coercion on governments and entities of third international locations, thus reinforcing the siege they’ve imposed for many years,” he stated.
“Predictably,’’ Mr. de Cossío added, “it has affected our individuals’s way of life, proscribing earnings, damaging important providers equivalent to electrical energy, water, transportation and well being care.”
Leaders of a number of Caribbean international locations have balked on the new visa rule and stated they’d fortunately forfeit journeys to the US.
Jamaica has as much as 400 Cubans, largely nurses, who’ve stuffed essential gaps within the nation’s medical care, stated Christopher Tufton, Jamaica’s minister of well being and wellness.
“We don’t have any proof that there’s trafficking going down,” Mr. Tufton stated in an interview.
In Trinidad and Tobago, the place 87 nurses and 9 medical doctors from Cuba work, the authorities have ensured that this system meets labor requirements, Prime Minister Stuart Younger stated.
“We stay grateful to Cuban well being care suppliers who present service in key areas to individuals of Trinidad and Tobago in circumstances that they and we may be happy with,” stated Amery Brown, a medical physician who serves as minister of international affairs. “The circumstances are literally glorious.’’
However a Cuban physician who had been posted in Port of Spain, the capital of Trinidad and Tobago, and who spoke on the situation her title not be revealed as a result of she fears reprisals, stated a lot of her $3,500 month-to-month fee was saved in a Cuban account that it was troublesome to outlive.
Mauricio Claver Carone, Mr. Trump’s envoy for Latin America and a longtime advocate for powerful sanctions on Cuba, stated extra international locations wanted to make use of a mannequin just like the one in Barbados, the place the federal government hires medical doctors straight.
“We wish to mainly have a united voice towards indentured servitude, towards human trafficking,” he stated.
In 2018, Ms. Matos sued the PanAmerican Well being Group, a U.N. company that had a task in managing this system in Brazil. She considers it “trendy slavery.”
“Isn’t {that a} slave, that you just limit an individual from going wherever they need, speaking to whoever they need?” she stated. “To not point out the salaries.”
Prior Beharry contributed reporting from Port of Spain, Trinidad and Tobago.
